Medicare puts the screws on doctor income

December 4, 2013

Australian GPs are being short-changed in comparison with many of their overseas colleagues, underlining complaints that Medicare rebates have failed to keep pace with rises in the cost of providing medical care.An international study of relative earnings by the Organisation of Economic Cooperation and Development has found that Australian GPs earned, on average, 1.7 times the average wage in 2011, putting them at the lower end of remuneration received by general practitioners in developed countries.The OECD’s Health at a Glance report (http://www.oecd.org/health/health-systems/health-at-a-glance.htm) found that self-employed GPs in the United Kingdom enjoyed the highest remuneration, earning 3.4 times the average wage in 2011, while their counterparts in Ireland, Canada and the Netherlands each earned three times the average income.The least flush GPs were those working in Hungary, who earned just 1.4 times the average wage, though the OECD warned this was probably an under-estimation because the figure only included general practitioners who were on the public payroll.Brisbane GP and AMA President Dr Steve Hambleton told the 6 Minutes news service the findings came as no surprise, given that the Medicare system had been “extraordinarily successful in keeping incomes down in Australia”.Bulk billing rates reached a record high of 82.4 per cent of all GP services in the first three months of the year, and the Labor Government froze Medicare rebates for an extra eight months, delaying the increase due last month to July next year, saving the Commonwealth an extra $664 million.The AMA President said the decision meant more of the burden of health care costs was being pushed onto GPs and their patients, and paid no heed to the relentless rise in the cost of running a practice and providing medical services.“These are tough fiscal times and GPs have been very generous with their time and margins to keep costs down for their patients,” Dr Hambleton said. “The Government has been relying on the goodwill of doctors for too long.” In a finding that will surprise few, the OECD report showed specialists were considerably better off than their GP colleagues.In Australia, they earned 4.3 times the average wage in 2011, putting them on a par with their peers in Canada and Austria and well ahead of most of their international counterparts. But their relative earnings were still considerably lower than specialists in Belgium (where they received 6.2 times the average wage) and the Netherlands (5.3 times the average).In further sobering reading for Australian practitioners, the OECD analysis suggested Australian practitioners were unlikely to close the earnings gap to the better-remunerated overseas colleagues any time soon.The Organisation found that remuneration growth for both GPs and specialists in Australia was modest by international comparison, growing at an average annual rate of 3.7 per cent and 3.9 per cent, respectively, between 2005 and 2011.By comparison, earning growth during this period was close to 4.5 per cent in Mexico and the Netherlands, and above 5 per cent in Israel and Belgium.The bright spot for Australian GPs was that this country was one of the few in the developed world where the annual gain in their remuneration broadly kept pace with that of specialists.Adrian Rollins